PMID- 28094753
OWN - NLM
STAT- MEDLINE
DCOM- 20170824
LR  - 20170824
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 35
IP  - 3
DP  - 2017 May-Jun
TI  - Quantifying cutaneous adverse effects of systemic glucocorticoids in patients 
      with rheumatoid arthritis: a cross-sectional cohort study.
PG  - 471-476
AB  - OBJECTIVES: EULAR guidelines state that adverse effects (AEs) of glucocorticoid 
      (GC) therapy should be considered and discussed with the patient before treatment 
      is initiated. However, reliable quantitative data, especially on cutaneous AEs of 
      low-to-medium dose GCs are lacking. We performed a study assessing the occurrence 
      of cutaneous AEs of GCs and its association with current and cumulative GC doses 
      in patients with rheumatoid arthritis (RA). METHODS: In a cross-sectional study 
      performed in 2 outpatient rheumatology centres, 381 RA patients were enrolled. 
      They were classed into 4 groups, according their mean daily dose during the past 
      12 months: 0 mg (n=87), <5mg (n=108), 5-7.5 mg (n=130), and >7.5 mg (n=56) of 
      prednisone equivalent. AEs of GC on the skin were assessed by physical 
      examination using a predefined scoring system, and by patients' self-assessments. 
      Data were analysed according GC dose categories and cumulative doses. RESULTS: 
      Cushingoid habitus, easy bruising, skin atrophy, and impaired wound healing as 
      reported by patients occurred significantly more frequently in those using a GC 
      the past 12 months, compared to those not using a GC. At physicians' assessments, 
      only Cushingoid habitus and ecchymosis were more prevalent in GC users. The 
      prevalence of these AEs was statistically significantly positively associated 
      with current and cumulative GC dose. There was low occurrence of abnormal stretch 
      marks, acne, perioral dermatitis, alopecia and hirsutism, which were not 
      correlated with GC use. CONCLUSIONS: Certain GC-associated cutaneous AEs are 
      common in RA, but other AEs of GC occur infrequently at the low-to-medium GC 
      doses used in RA.
FAU - Amann, Jonna
AU  - Amann J
AD  - Department of Rheumatology and Clinical Immunology, Charite University Medicine, 
      Berlin, Germany.
FAU - Wessels, Anne-Marie
AU  - Wessels AM
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, the Netherlands.
FAU - Breitenfeldt, Friederike
AU  - Breitenfeldt F
AD  - Department of Rheumatology and Clinical Immunology, Charite University Medicine, 
      Berlin, Germany.
FAU - Huscher, Dorte
AU  - Huscher D
AD  - German Rheumatism Research Center Berlin, Epidemiology, Berlin, Germany.
FAU - Bijlsma, Johannes W J
AU  - Bijlsma JWJ
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, the Netherlands.
FAU - Jacobs, Johannes W G
AU  - Jacobs JWG
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, the Netherlands. j.w.g.jacobs@umcutrecht.nl.
FAU - Buttgereit, Frank
AU  - Buttgereit F
AD  - Department of Rheumatology and Clinical Immunology, Charite University Medicine, 
      Berlin, Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170115
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Aged
MH  - Arthritis, Rheumatoid/diagnosis/*drug therapy
MH  - Atrophy
MH  - Contusions/chemically induced/epidemiology
MH  - Cross-Sectional Studies
MH  - Cushing Syndrome/chemically induced/epidemiology
MH  - Dose-Response Relationship, Drug
MH  - Ecchymosis/chemically induced/epidemiology
MH  - Female
MH  - Germany/epidemiology
MH  - Glucocorticoids/administration & dosage/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Risk Assessment
MH  - Risk Factors
MH  - Self-Assessment
MH  - Skin/*drug effects/pathology
MH  - Skin Diseases/*chemically induced/diagnosis/epidemiology
MH  - Time Factors
MH  - Treatment Outcome
MH  - Wound Healing/drug effects
EDAT- 2017/01/18 06:00
MHDA- 2017/08/25 06:00
CRDT- 2017/01/18 06:00
PHST- 2016/07/05 00:00 [received]
PHST- 2016/11/10 00:00 [accepted]
PHST- 2017/01/18 06:00 [pubmed]
PHST- 2017/08/25 06:00 [medline]
PHST- 2017/01/18 06:00 [entrez]
AID - 10882 [pii]
PST - ppublish
SO  - Clin Exp Rheumatol. 2017 May-Jun;35(3):471-476. Epub 2017 Jan 15.